1437742343 NPI number — A TRUE PROFESSIONAL LLC

Table of content: (NPI 1487612867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437742343 NPI number — A TRUE PROFESSIONAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A TRUE PROFESSIONAL LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437742343
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 S STATE ROAD 7 STE 344
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33023-7203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-404-6600
Provider Business Mailing Address Fax Number:
877-384-2630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 S STATE ROAD 7 STE 344
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIRAMAR
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33023-7203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-404-6600
Provider Business Practice Location Address Fax Number:
877-384-2630
Provider Enumeration Date:
02/11/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOONE
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
B
Authorized Official Title or Position:
OWNER/MANAGER
Authorized Official Telephone Number:
786-510-2799

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)